Abstract: A balloon catheter which has an elongate shaft with an inflatable balloon connected to its distal end and a manifold connected to its proximal end. The manifold may be fixedly or removably attached to the shaft and includes a barrel with a plunger movably disposed inside it. The barrel has an internal volume of less than 5 cc and an internal diameter of less than 0.25 inches. A pressure transducer may be mounted to the manifold to permit measurement via a sensor tube. A pressure source for a balloon catheter including a barrel with a plunger inside it. The barrel is in fluid communication with the inflation lumen of the catheter and has an internal volume less than 5 cc and an internal diameter of less than 0.25 inches. A pressure sensor may be connected to the barrel with a sensor tube defining a fluid path from the interior of the barrel to the pressure sensor. A lock mechanism may be connected to the barrel to control longitudinal movement of the plunger.

Abstract: An improved aortic cannula is provided for use in heart by-pass surgery. The cannula includes an elongated tube with a terminal end. The terminal end has a ramped surface leading to the discharge opening. The ramped surface terminates in a spoon-shaped lip. The spoon-shaped lip directs blood out of the cannula opening toward the ascending aorta or aortic arch in a U-shaped dispersion so as to preclude impact on the aortic wall. A bead adjacent the opening facilitates dispersion of the exiting blood. The opening has an upper edge with an inverted V-shaped contour which also facilitates dispersion of the blood.

Abstract: A catheter and method of use as an aortic balloon catheter having an integral expandable/collapsible lumen. The catheter comprises a main catheter body having a plurality of lumens extending therethrough, and further includes an expandable/collapsible lumen disposed thereabout and carried by the main catheter body. The expandable/collapsible lumen has a relatively large diameter when inflated with respect to the main catheter body, and is self-inflating by fluid pressure when the fluid flows therethrough. The large inflatable/collapsible lumen is attached at its distal end to the main catheter body and thus is carried therewith into a body vessel, and thus is also supported by the catheter body to avoid kinking.

Abstract: What is disclosed is a portable and modular cardiopulmonary bypass apparatus and method. The apparatus includes (i) a first cannula assembly for withdrawing blood from a patient, (ii) a pump connected to the first cannula assembly for receiving the withdrawn blood and for moving the blood through the apparatus, and (iii) a first tubing connected to the pump to transport the patient's blood away from the pump. The apparatus also includes (iv) an oxygenator for receiving blood from the first tubing and for oxygenating the blood and (v) a second cannula assembly connected to the oxygenator for returning the oxygenated blood to the patient. The apparatus may be portable so that it can be used by medical personnel anywhere. In addition, the apparatus is adapted to included one or more modules for conditioning the blood, such as modules that include a heat exchanger, blood purifier, plasma and blood cell apheresis device and others. An aortic balloon catheter is also provided.

Abstract: A right coronary artery catheter including a hub, a linear flexible tubular body stock extending from the hub and a curved flexible tubular stem extending from the body stock. The stem includes a distal end, a primary curved section and a secondary curved section. The primary curved section is positioned between the distal ends of the stem and body stock. The secondary curved section is positioned between the primary curved section and the distal end of the body stock, and extends in a direction generally opposite the direction of the primary curved section.

Abstract: Methods are provided for conducting surgical procedures in a patient wherein, during the surgical procedure, autonomous ventricular electrical conductivity and escape beats are reversibly and transiently suppressed to facilitate the surgical procedure. Also provided are compositions which are capable of inducing ventricular asystole in a patient. The compositions may include an AV node blocker. In one embodiment, compositions including an atrioventricular (AV) node blocker and a .beta.-blocker are provided, wherein the .beta.-blocker is present in an amount sufficient to substantially reduce the amount of AV node blocker required to induce ventricular asystole in the patient. The compositions and methods may be used for inducing temporary ventricular asystole in a beating heart, and to facilitate the performance of a variety of surgical techniques, including minimally invasive microsurgical techniques.

Abstract: A catheter having an elongate body including a central lumen adapted to slidably receive a therapeutic catheter. The catheter includes a soft tip adapted to lodge in the ostium of the right coronary artery. The elongate body is formed near the distal end to impinge against the wall of the aorta opposite the ostium of the coronary artery.

Abstract: A catheter having an elongate body including a central lumen adapted to slidably receive a therapeutic catheter. The catheter includes a soft tip adapted to lodge in the ostium of the right coronary artery. The elongate body is formed near the distal end to impinge against the wall of the aorta opposite the ostium of the coronary artery.

Abstract: A medical catheter including a continuous liner defining a guidewire lumen. The liner has a constant inner diameter and a constant outer diameter. A continuous layer is braided over the liner and encapsulated between the liner and a bump layer. The bump layer has a proximal segment, and a bump section. The bump section has a transition zone at the proximal end of the bump section. The proximal segment has a distal end affixed to the proximal end of the bump section. The proximal segment of the bump layer has an outer diameter which is less than the outer diameter of the bump section of the bump layer. The transition zone has an outer diameter which smoothly transitions from the outer diameter of the distal end of the proximal segment of the bump layer to the larger outer diameter at the distal end of the transition zone. The bump layer is encapsulated between the outer jacket layer and the braided layer.

Abstract: A catheter has a stylet formed of a shape-retentive and resilient material having a preformed curved shape at its distal end resulting in the catheter sheath having the preformed curved shape. The catheter sheath has a plurality of electrodes at its distal end for contacting selected biological tissue for imparting ablation energy thereto. The catheter sheath also has an axially mounted tendon for causing deflection of the distal end. The stylet material permits straightening the catheter sheath during insertion into the patient and advancing the electrodes to the target tissue. Upon removal of the straightening forces, such as by entry into a chamber of the heart, the stylet material resumes its preformed curved distal shape thereby forcing the catheter distal end with the electrodes into the same preformed curved shape.

Abstract: Methods are provided for conducting surgical procedures in a patient wherein, during the surgical procedure, autonomous ventricular electrical conductivity and escape beats are reversibly and transiently suppressed to facilitate the surgical procedure. Also provided are compositions which are capable of inducing ventricular asystole in a patient. The compositions may include an AV node blocker. In one embodiment, compositions including an atrioventricular (AV) node blocker and a .beta.-blocker are provided, wherein the .beta.-blocker is present in an amount sufficient to substantially reduce the amount of AV node blocker required to induce ventricular asystole in the patient. The compositions and methods may be used for inducing temporary ventricular asystole in a beating heart, and to facilitate the performance of a variety of surgical techniques, including minimally invasive microsurgical techniques.

Abstract: A cannula for draining blood from a patient's heart during cardiac surgery including a main body and a pair of branches extending distally therefrom. The branches are biased to extend away from one another by pre-shaped stiffening elements, and have "D" shaped cross-sections defining flat surfaces oriented generally towards one another. The branches may be constrained in a retracted position, the flat surfaces abutting one another, and the resulting profile forming a substantially continuous extension of the main body. The branches have distal tips including drainage holes and occlusion balloons, and elbow portions including accordion-like ridges for preventing kinking. Grooves in the flat surfaces define a secondary lumen in the retracted position through which a cardioplegia delivery or an imaging device may be advanced. The cannula is directed into a trocar to constrain the branches in the retracted position, and the trocar is inserted into the right atrium.

Abstract: In one aspect of the present invention, a cardiac lead is provided that includes a connector for coupling to a cardiac stimulator that has a first rotatable member, and a tubular insulating sleeve that has a first end coupled to the connector and a second end. A tip assembly is coupled to the second end. The tip assembly has a second rotatable member. A coiled wire is coupled between the first rotatable member and the second rotatable member. The coiled wire is composed of a shape-memory material and is operable to transmit torque between the first rotatable member and the second rotatable member. Where the lead is provided with a bend, the shape-memory coiled wire retains a straight set, enabling smooth rotation of a fixation corkscrew without precession of the lead tip.

Abstract: An angioplasty guide catheter adapted for use within a cardiovascular system and cooperable with a left main coronary artery. The guide catheter has a distal end portion such that with a distal tip of the distal end portion coaxially intubated within an ostium of the left main coronary artery fully disposed within the cardiovascular system, a portion of the distal end portion rests against and is substantially contiguous with a wall of the ascending aorta. A distal end of the resting portion is substantially directly opposite the ostium of the left main coronary artery and a portion of the distal end portion defines a generally rectilinear axis of support extending from the distal end of the resting portion across the ascending aorta to the ostium of the left main coronary artery.

Abstract: A catheter system for use in minimally invasive cardiac surgical procedures. The catheter system diminishes certain trauma generally associated with invasive cardiac procedures while providing aortic occlusion, extracorporeal circulation, cardiac arrest, and cardiac venting. The catheter system provides a minimally invasive and simplified system that performs total cardiopulmonary bypass with ease of insertion, improved whole body profusion, and shortened recovery periods. The catheters are refined, with reduced diameters and specialized functions for maximum control of each aspect of cardiopulmonary bypass.

Abstract: A precurved cardiac introducer sheath (4) includes an elongate, hollow body having main and tip portions (24, 22). The tip portion includes first through fifth segments (26, 28, 30, 32, 34). The first, second, and third segments lie in a first plane (36) while the fourth and fifth segments lie in a second plane (38) oriented at a second angle (37) of about .+-.10 to 170.degree. to the first plane. The second segment defines an arc extending along a first, included angle of about 90-110.degree. while the fourth segment defines an arc extending along a third, included angle of about 90-140.degree. . The first, third, and fifth segments are preferably generally straight segments. The precurved introducer sheath is preferably configured to direct the electrophysiology catheter (18) directly at the posterior region (52) of the left atrium (40). The precurved introducer sheath is preferably housed within an outer introducer sheath (46) having a radially deflectable distal end (46), or a fixed distal curve.

Abstract: A cannula for conducting fluid to a body includes a cannula body having proximal and distal ends and a lumen extending therebetween. The lumen is adapted to receive the fluid flowing therethrough. The cannula also includes a cannula tip, which is coupled to the distal end of the cannula body. The canula tip includes a side wall having a plurality of fluid outlets formed therein. Each fluid outlet is directed toward the proximal end of the cannula body to reverse the flow of fluid exiting the cannula by an obtuse angle from the original direction of flow.

Abstract: A spiral balloon perfusion catheter assembly having a retaining wire and method of making the balloon. Also, a retaining wire for such a catheter and method of forming the retaining wire. A typical spiral catheter balloon has a spiral configuration of lobes and channels mounted on a catheter extending beyond the balloon ends. A retaining wire formed from a shape memory alloy is configured to have a central region having a spaced spiral configuration conforming to the spiral balloon channel and end regions configured to have a contiguous spiral configuration conforming to the catheter diameter. When placed over a spiral balloon, the central spiral region prevents expansion of the channel when the balloon is inflated, while the end regions secure the retaining wire to the catheter. Preferred shape memory alloys comprise nickel and titanium.

Abstract: Methods are provided for conducting surgical procedures in a patient wherein, during the surgical procedure, autonomous ventricular electrical conductivity and escape beats are reversibly and transiently suppressed to facilitate the surgical procedure. Also provided are compositions which are capable of inducing ventricular asystole in a patient. The compositions may include an AV node blocker. In one embodiment, compositions including an atrioventricular (AV) node blocker and a .beta.-blocker are provided, wherein the .beta.-blocker is present in an amount sufficient to substantially reduce the amount of AV node blocker required to induce ventricular asystole in the patient. The compositions and methods may be used for inducing temporary ventricular asystole in a beating heart, and to facilitate the performance of a variety of surgical techniques, including minimally invasive microsurgical techniques.

Abstract: A two-staged venous cannula is disclosed having an angled bend near the distal end. In a preferred embodiment, the angle is a right angle. The angle bend allows the cannulation to take place near the junction of the inferior vena cava and the right atrium instead of higher in the right atrium. The cannula has a drainage hole at the apex of the angled bend to act as a blood collection port and a drainage hole at the distal end of the cannula to drain the inferior vena cava. The two-stage venous cannula is made of a rigid material at its distal end so that the distal end of the cannula may be easily inserted into the patient's heart through the right atrium. The disclosed cannula keeps the cannula away from the aorta, allows the cannula to exit the superior vena cava at an angle more perpendicular to the axis of the superior vena cave and allows the cannula to be used in minimally invasive surgical procedures where size and access restrictions often make it difficult to place and maintain such devices.

Abstract: A coronary artery angiographic and percutaneous transluminal coronary angioplasty guiding catheter includes a substantially tubular distal top portion having an open distal end, a substantially tubular proximal main portion, and a substantially tubular bend portion connectively provided between the distal top portion and the proximal main portion. An inclined portion is formed at the distal end of the distal top portion. The inclined portion is inclined such that a length of the distal top portion is shorter on an inside periphery of the bend portion than on an outside periphery of the bend portion. The inclined portion includes a closed portion being bent and sealed.

Abstract: A conformable catheter comprising a catheter handle, an elongated catheter tube, and a distal tip portion of the catheter tube, capable of assuming a desired pre-programmed shape. A wire member is disposed within the core of the catheter's tip portion and is formed of a material, such as, for example, a shape-memory binary nickel-titanium alloy, that will assume a pre-programmed shape after pre-shaping, heat treatment, cooling and subsequent heating. To pre-program the shape of the wire member, prior to assembly of the catheter, the wire member is wound around a shaped, heat resistant fixture, heated until the temperature of the wire member exceeds the temperature at which the shape of the wire member on the fixture becomes programmed into the wire member, and cooled.

Abstract: A catheter for the right coronary artery where the catheter includes a substantially straight proximal shaft section and a distal shaft section. The distal shaft section includes a support arm which is sized to traverse the aortic root such that the one end of the support arm rests against the aortic wall opposite the right coronary ostium and the other end of the support arm rests in the right coronary ostium. The support arm provides for increased back-up support by utilizing the opposite aortic wall. The distal shaft section further includes a tertiary curve disposed proximal of the support arm. The tertiary curve has an arc angle of less than about 90 degrees such that torque may be readily transmitted from the proximal shaft section to the support arm thereby facilitating controlled tip manipulation. Methods of using such a catheter are also disclosed.

Abstract: A left coronary guide catheter having primary, secondary and tertiary curves formed therein to facilitate insertion and positioning of the distal tip of the catheter within the left coronary ostium. The distal portion of the catheter may be formed of material which is softer than the remainder of the catheter.

Abstract: A guide catheter for insertion into the cardiovascular system having a straight portion and an improved distal end portion for more precise and easier positioning in a left coronary artery. The improved distal portion includes a secondary curved portion, followed distally by a primary curved portion, terminating with a distal tip portion. The primary and secondary curved portions have an approximately equal curvature radii when the distal tip portion is postioned in the ostium of the left coronary artery, thereby forming a constant radius curve.

Abstract: A catheter for evaluating the competency of a mitral valve has a main lumen and at least one additional lumen for venting the area immediately adjacent the catheter. The vent lumen has multiple vent apertures provided along the length thereof to ensure thorough venting. Preferably, a third lumen fluidly connected to a pressure-sensing device is also integrally formed into the catheter. In practice, the distal end of the catheter is inserted through an access aperture formed in the aorta, passed through the aortic valve into the left ventricle. Pressurized fluid is injected into the left ventricle through the main lumen of the catheter. The fluid pressure within the left ventricle is monitored through the pressure-sensing lumen while the surgeon visually inspects the valve competency. The vents are utilized prior and subsequent to evaluating the competency of the valve for removing air and fluid from the area adjacent the catheter.

Abstract: The present disclosure is directed to a perfusion stent and method for implanting the same in a TMR channel for perfusing blood to ischemic areas of the head. The stent includes a head and a stem extending perpendicular to the head. The stem includes a cylinder having a plurality of holes. The method comprises the steps of creating the TMR channel, and implanting the perfusion stent within the TMR channel in order for blood within a ventricle to enter the stem and be perfused to the heart muscle.

Abstract: A steerable catheter is disclosed which includes a complexly curved proximal section shaped to seat the catheter relative to an anatomical feature within a patient. The catheter also includes a flexible intermediate section which has comparatively greater flexibility than other sections of the catheter. The flexible intermediate section bends in response to forces applied by an attached steering device and substantially all of the flex in the catheter may be contained within the flexible intermediate section. The catheter further has a pre-shaped distal section which is urged into contact with tissue within the patient when the flexible intermediate section flexes. In a preferred embodiment, the distal section supports a plurality of ring electrodes and is shaped to generally correspond to the physiology of a wall of the heart.

Abstract: Right and left coronary catheters that are designed to be used in a transradial coronary catheterization are provided. The catheters have a proximal end, an extended body portion, and a shaped distal end with two curved portions and a tip. When advanced into the ascending aorta, the curved portions of the distal end cooperate with the aorta to engage and maintain the tip of the catheter within the selected coronary ostium during a coronary procedure. Also provided are methods of inserting the catheters into a right or left coronary artery by a transradial approach, and using the catheters in a diagnostic or interventional procedure to selectively deliver an imaging dye or tool to the coronary artery of interest.